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LGBT Forum Chair
Stephan Davis, DNP, FACHE
ACHE LGBTQ Forum Chair
MHA Director and Assistant Professor
University of North Texas Health Science Center, School of Public Health
Fort Worth, Texas
Dear Colleagues,
As I shared in our inaugural video address to the forum, and the broader community of LGBTQ patients, professionals, executives and allies, I am so honored to chair ACHE’s LGBTQ Forum, a diverse community of executives who are leading healthcare organizations amid the COVID-19 pandemic.
It’s humbling to serve such remarkable and dedicated healthcare leaders and to further the legacy of our previous chairs: Dr. Dan Gentry, president/CEO of AUPHA; Bob Chaloner, an accomplished hospital executive; and Dr. Ken White, the first openly gay man to receive ACHE’s highest honor, the Gold Medal Award.
I am also honored to be the first person of color and millennial to lead the forum because living at the intersection of identities has informed my perspective as a leader and has inspired me to be an ally to underrepresented and excluded groups to which I do not personally belong.
It is in this spirit that we will continue the work of the forum. My vision is for us to create a larger and increasingly diverse forum, with more women contributing to leadership, more people of color at the forefront, and both current and aspiring healthcare leaders across generations coming together for the betterment of our community.
I also seek greater involvement from our allies who may not identify as gender or sexual minorities but who understand the importance of eradicating disparities faced by our community and improving the ability of minority leaders to fully realize their potential.
As we enter Pride Month, I am reminded of how far we have come as a community. I am so proud of our progress and hopeful of where we might go. In the famous words of Dr. Martin Luther King Jr., we will someday reach the “promised land.”
Despite these challenging and unprecedented times, “our band will play on.” We will continue to march forward toward a more inclusive tomorrow. As such, Dr. Cie Armstead and I invite you to our inaugural virtual Pride Month LGBTQ Forum business meeting on Saturday, June 27 at 12 p.m. Central time. As Pride events are being cancelled across the nation, the theme of our meeting is “No Rain On Our Parade: Advancing LGBTQ Health Equality.” We look forward to seeing you on the 27th!
Thank you for all that you are doing to lead change and advance health!
Stephan
ACHE LGBTQ Forum Executive Profile
Marie J. Webber, FACHE
Chief Administrative Officer
UC San Diego Health
1. What inspired you to pursue a career in healthcare administration?
Fortunately, I found health administration at a very young age. By the age of 19, I had a lot of experience with the healthcare system as a patient. I attended a career night at Eastern Michigan University’s School of Public Health during the fall of my first year of college. The program director and professor, Richard Douglass, encouraged me to explore healthcare administration, and he suggested I take his class to learn more. His stories about running a hospital were so inspiring!
The profession connected me with my desire to improve the care for patients, as well as support the physicians and nurses who are on the front lines. I love everything about healthcare operations and the complexity of its challenges. It is a truly fulfilling career where we can make a difference in the lives of others, improve the delivery system and work as a team.
2. What have been the hallmarks of your career in healthcare leadership?
The most important and unique attributes that have marked my career in healthcare leadership are authenticity and empathy. Being my true self and listening and connecting with patients and team members have enabled me to be a responsive and thoughtful leader. I have learned values and trust help form the relationships needed to be a successful leader and successful in change management.
Over the past year, I was fortunate to co-chair a workgroup that trained over 4,000 team members about sexual orientation and gender identity (SOGI). The clinical team was able to connect with our patients in a more competent way and capture SOGI information on over 50% of patients, which enabled better healthcare and improved our outcomes.
3. Do you believe being a member of the LGBTQ community or an LGBTQ champion impacts career advancement for healthcare leaders?
Yes! First, being a member of the LGBTQ community brings unique challenges, such as how we show up as our true selves at work and what it has taught us. That authenticity and being able to connect with others and relate through our own lived experience is a big advantage. Second, LGBTQ champions show their empathy, compassion, and support for diversity and inclusion, and this is such an important career necessity for healthcare leaders. As leaders, we must be able to connect and show compassion for our patients and our team. To understand the unique individual challenges, see opportunities to do things in new ways and inspire others by connecting with them on a deeper human level are key to successful leadership and, ideally, advancement.
4. What would be your advice to LGBTQ individuals pursuing careers in healthcare management?
Healthcare management is one of the most rewarding professions I could have chosen to pursue. When I was a young professional, I felt a little insecure about the professional ceiling as both a woman and LGBTQ leader. To my surprise, the entire profession is full of nurses, doctors, allied professionals and management who are kind, caring and compassionate. They also chose this field for similar reasons. We are connected by our values and code of ethics, especially ACHE members. It is truly rewarding to work in a supportive profession where everyone has a common goal to improve healthcare and create a healthier world. My advice is to be yourself, do amazing work and show up ready to lead yourself and others to improve every day.
5. Why did you decide to join the LGBTQ Forum, and what do you feel is the value added by this group?
I joined the LGBTQ Forum to network with other LGBTQ individuals and allies, as well as to learn about diversity and inclusion efforts for LGBTQ executives. I was interested in the senior leaders’ stories and encouragement, and it gave me hope that I could aspire to any level of leadership with continuous learning. It was important to see others like me who were able to achieve success in their careers as leaders. I feel the continued advocacy and collaborative community are a value-add for LGBTQ individuals and allies who want to improve their diversity and inclusion efforts as well as to develop their leadership competencies.
LGBTQ Forum Organizational Profile
Oklahoma City Indian Clinic established a Diversity Council and Transgender Treatment Team to work side-by-side and address LGBTQ inequalities throughout the organization. One of the first deficiencies we noticed was that our nondiscrimination policy, although already in place, did not address gender identity or expression.
The OKCIC Diversity Council revised the policy, which now reads, “Oklahoma City Indian Clinic (OKCIC), as your medical home, will always strive to provide a safe, welcoming and culturally appropriate clinic environment that does not discriminate against any person on the basis of gender identity, gender expression, sexual orientation, or transgender status so that all LGBTQ+ patients will be treated with respect, and according to their gender identity.” 2. How has the organization engaged LGBTQ patients and/or the local LGBTQ community?
We use publications to reach out to our local LBGTQ population, expressing our dedication to them, their inclusion and their healthcare. Our latest publication can be found here.
To expand our reach into the community, Prevention Specialist Lisa Toahty works daily with local organizations to meet each patient at the point of their needs. OKCIC participates in the Oklahoma HIV Prevention CO-OP to provide safer-sex packs in the gay community as well as outreach events providing free HIV testing and education. OKCIC attends the Oklahoma City Pride Festival every year and offers information on our services at the clinic and how to get registered as a patient.
3. How has the organization advanced inclusion for healthcare professionals and leaders?
The OKCIC nondiscrimination policy and clinic-wide inclusion standards not only apply to patients but also to employees and potential hires. OKCIC prides itself on inclusion and acceptance. All employees and healthcare professionals are included and encouraged to join the OKCIC Diversity Council. In fact, we have “Community Champions” who are actively engaged in the LGBTQ community that serve on this council. This allows us to be grounded in truth and ensure we are meeting the needs of our community.
4. How has the organization worked to advance health and clinical outcomes for the LGBTQ population?
OKCIC has expanded clinical services to address the needs of the AI/AN LGBTQ community. Services now include PEP and PrEP therapy, hormone management for adults facilitated by our board-certified endocrinologists, comprehensive men’s/women’s health, and LGBTQ-focused behavioral health services. These services are in addition to the general clinic services that are available to all AI/AN patients in the Oklahoma City area. These include, but are not limited to, pharmaceutical interventions including hepatitis C treatment and tobacco cessation, dental, optometry, health promotion disease prevention, public health, and physical therapy services.
The LGBTQ Community and COVID-19
By Jake Reyna-Casanova
The Human Rights Campaign Foundation put together a “brief [that] has summarized the ways in which COVID-19 could adversely affect the lives and livelihood of the LGBTQ community at a disproportionate rate.”1 While the full brief can be found here, below is a synopsis of the ways the United States’ LGBTQ community may be more at risk during the COVID-19 pandemic.
As the number of COVID-19 cases has surpassed the 1 million mark in the U.S., the LGBTQ population faces unique challenges. First and foremost, the HRC Foundation estimates there are nearly 14 million LGBTQ adults and 2 million LGBTQ youth in the U.S. Of the adult population, more than 5 million (more than a third of the community) work in jobs that are more likely to be impacted by COVID-19. The impacts include being more at risk for exposures or more likely to lose their jobs. These jobs include working in restaurant and food services (approximately 2 million LGBTQ individuals), hospitals (1 million), K-12 education (almost 1 million), colleges and universities (nearly 1 million), and retail (half a million). For comparison, only roughly 22% of non-LGBTQ individuals work in these five industries. As of March 19, 2020, at least 15 states ordered all dine-in restaurant services to stop, meaning that some of the 2 million LGBTQ individuals in this industry are currently without a job. LGBTQ healthcare workers are at an increased risk of exposure. And, many teachers and professors have had to completely change their lesson plans to be accessible virtually, while receiving little to no support.
Nearly 10% of LGBTQ people are unemployed, and about 22% of LGBTQ adults live in poverty, compared to 16% of their cisgender, straight counterparts. The poverty rates are even higher for the transgender community (29%) as a whole and more significant for the black (40%) and Latinx (45%) transgender communities. The already high unemployment rates and poverty rates within the community are expected to be exacerbated by COVID-19. LGBTQ people who have jobs may not have access to ample paid leave to care for themselves or their loved ones.
These high unemployment and poverty rates also lead to a high uninsured rate or low accessibility to affordable primary healthcare. Nearly 17% of LGBTQ adults do not have any kind of health insurance coverage, compared to 12% of non-LGBTQ adults. Furthermore, 23% of LGBTQ adults of color, 22% of transgender adults and 32% of transgender adults of color have no form of health coverage. This can lead to avoiding medical care, even when medically necessary, and severe economic hardship when medical care is ultimately accessed.
Older LGBTQ people and LGBTQ youth also face unique challenges. Older people already face systemic discrimination in housing, employment and healthcare, which indirectly exacerbates health disparities and social isolation among aging LGBTQ people. According to SAGE, older LGBTQ people are two times as likely to live alone and four times less likely to have children, which during this time of the pandemic is dangerous due to the lack of care or support. For the LGBTQ youth population, they are more likely than straight, cisgender youth to experience homelessness, unstable housing or placement in foster care. This means many LGBTQ youth are dependent on the food and resources they receive from public school and child welfare agencies. They may also be required to spend more time in unsupportive environments, which can lead to many other health issues.
There are many situations in which LGBTQ individuals are more at risk, as compared to their non-LGBTQ counterparts, in suffering from economic or health problems during the pandemic. It is crucial now more than ever that “responses to COVID-19 taken by the government, policymakers and the private sector actively consider the unique situations of LGBTQ people in their plans for addressing this crisis.”1 As healthcare leaders, we can be sure we do our part in ensuring the safety of not only our LGBTQ patients but also our colleagues who may be going through difficult times now due to their identity.
Stay well. Stay healthy.
1 Whittington, Charlie, et al. The Lives & Livelihoods of Many in the LGBTQ Community Are At Risk Amidst COVID-19 Crisis. Human Rights Campaign Foundation, 20 Mar. 2020, assets2.hrc.org/files/assets/resources/COVID19-IssueBrief-032020-FINAL.pdf.
Leadership Lessons from COVID-19: A Conversation With Florence Di Benedetto
Senior Vice President/General Counsel
Sutter Health
Sacramento, Calif.
ACHE has partnered with The Equity Collaborative to support its mission to accelerate progress in achieving institutional gender equity and promoting fully inclusive gender equity across the healthcare industry. TEC was launched in 2019 as part of the Carol Emmott Foundation to bring together large healthcare systems, working collaboratively to fulfill its mission. Sutter Health is one of the TEC founding organizations, and Florence “Flo” Di Benedetto, senior vice president/general counsel, shares with us her experiences leading through the COVID-19 crisis. Look for part two of our conversation with Flo in the next issue.
1. Briefly describe your role(s) and main responsibilities in your organization’s response to the COVID-19 crisis.
At Sutter Health, I serve as the senior vice president and general counsel. In that capacity, I have accountability for Legal Services, Risk Services, and Privacy and Information Security, including cyber security. The Sutter Health Emergency Management System reports to me through Sutter’s chief risk officer. SHEMS coordinates systemwide responses to all kinds of disasters or crises, including wildfires, floods, network outages and pandemics, such as SARS, H1N1 and now COVID-19. In addition to having overall management responsibility for SHEMS, I am privileged to serve as one of Sutter’s incident commanders for this pandemic. I rotate this role with three senior vice presidents. We each take four days as incident commander, four days of night call and then other Command Center duties as assigned.
2. What are one or two leadership lessons you’ve learned or were reminded of during this crisis?
SHEMS has been activated on many occasions in the last five years, most recently and notably, to deal with massive wildfires such as the 2017 Tubbs fire, which forced the evacuation of Sutter Santa Rosa Regional Hospital, and the 2018 Mendocino fire, which forced the evacuation of Sutter Lakeside Hospital. Each of these fires not only resulted in the evacuation of our hospitals but also displaced hundreds of our employees and clinicians who lived in the areas impacted by mandatory evacuation orders.
Each time I served as the incident commander for one of these crises, I was reminded of the importance of being decisive and steadfast, often with limited information. Emotion, panic or fear must be modulated and contained. You deal with the issue clearly and decisively and move on to the next. I equate running a Command Center during a crisis to running a MASH or Trauma Unit. The pace is intense and relentless.
The other important lesson about leadership—of which I am reminded every day—is that it’s not about me as a leader. It’s about the team. My job as a leader is to make decisions, give clear direction and then let the team do its job. Leaders facilitate the success of their teams, in whatever form that facilitation takes. Whether it’s removing barriers, finding resources, or coaching and counseling, it’s all about the team—it’s not about me.
3. What are your perspectives on these health disparities that LGBTQ Americans are facing during the pandemic, disparities that existed before COVID but are exacerbated by the virus?
From the perspective of a senior executive at Sutter Health, I can tell you we absolutely recognize health disparities exist and impact multiple populations. Within our Northern California footprint, Sutter Health serves some of the most diverse patient populations in the nation. At Sutter Health, we believe every patient deserves the most optimal treatment and outcome, regardless of their background, ethnicity, gender, sexual orientation, gender identity or any other unique factor.
We have developed a Health Equity Index, which uses analytics to measure outcomes across a variety of patient populations. From a patient standpoint, we are committed to providing every patient with a safe, personal, accessible and affordable experience, regardless of their background. From an employee standpoint, we have an active Diversity and Inclusion Program that includes the LGBTQ community, and each of the inclusion groups in this program is sponsored by a senior vice president.
As an employer, Sutter is proud of its health benefits for our LGBTQ staff, such as in vitro fertilization for same-sex couples. We have one of the first transgender clinical programs in the country. We have offered employee assistance, including our Employee Assistance Program, which is a confidential service connecting the employee to a myriad of experts who can assist with virtually anything that is causing stress and anxiety in the employee. In times of crises like this pandemic, we also offer salary continuation programs, an employee assistance fund and very expansive leave programs that are available to our workforce regardless of their race, ethnicity, sexual orientation, gender identification or any other unique characteristic.
ACHE News and Upcoming Events
EDCN Webinar Series
As a result of the unprecedented events of COVID-19, working in today’s environment is challenging for healthcare executives. ACHE has developed a webinar series, using the Executive Diversity Career Navigator, about managing careers during today’s challenges. Register for upcoming webinars in the series:
Post-Pandemic Job Market: How to Prepare and Not Panic
June 4
3–3:45 p.m. Central time
Self-Care to Care for Others in Crisis
June 11
3–3:45 p.m. Central time
Save the Date
Join ACHE and Tari Hanneman, director, Health and Aging Program, Human Rights Campaign Foundation, for an upcoming webinar “The LGBTQ Community and COVID-19,” on Thursday, June 25, 11 a.m. Central time. LGBTQ Forum members will receive more information in June and will be posted on the LGBTQ Forum website.
LGBTQ Forum Business Meeting
No Rain On Our Parade: Advancing LGBTQ Health Equality
Saturday, June 27
12 p.m. Central time
More details to come.
2019-2020 Committee Members
Chair
Stephan Davis, DNP, FACHE
MHA Director and Assistant Professor
University of North Texas Health Science Center, School of Public Health
Fort Worth, Texas
Timothy M. Carrigan, PhD, RN, FACHE
Chief Nursing Officer
Loyola Medicine
Maywood, Ill.
Amir Farooqi, FACHE
Associate Director (Chief Operations Officer)
Tuscaloosa (Ala.) VA Medical Center (VISN 7)
**Kelly Brian Flannery, FACHE
VISN 21 Chief Planning Officer
VA Sierra Pacific Network (VISN 21)
Vallejo, Calif.
Daniel Gentry, PhD
(Immediate Past Chairman)
President/CEO
Association of University Programs in Health Administration
Washington, D.C.
LTC Charlotte L. Hildebrand, PhD, FACHE
U.S. Army
**Johnathan W. Prins, RN, FACHE
Director of Clinical Operations
Cedars Sinai Medical Care Foundation
Los Angeles
**Faith D. Solkoff, RN
Corporate Vice President, Quality & Accreditation Operations
Baptist Health South Florida
Coral Gables, Fla.
Amanda S. Tufano
CEO
Genevive
Minneapolis
**Marie J. Webber, FACHE
Chief Administrative Officer
UC San Diego Health
San Diego
**2020-21 New Members
Chapter Liaison
South Texas Chapter of the American College of Healthcare Executives
Jake Reyna-Casanova
Senior Development Associate
CommuniCare Health Centers
San Antonio
STAFF CONTACT
Cie Armstead
Director of Diversity and Inclusion
American College of Healthcare Executives
300 S. Riverside Plaza, Suite 1900
Chicago, IL 60606
(312) 424-9306
carmstead@ache.org
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Tell a Colleague About the LGBTQ Forum
As one of the nearly 200 members of ACHE’s LGBTQ Forum, you have helped to create a vibrant community of LGBTQ healthcare leaders and allies exchanging ideas to further your career and advance the forum’s mission. Now continue the growth of the forum and expand its diversity by encouraging your fellow ACHE colleagues to join the LGBTQ Forum. Invite them to join today at ache.org/LGBTQ.
Please note that any views or opinions presented in this online newsletter are solely those of the author and do not necessarily represent those of ACHE.